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Most Insurers in Massachusetts Still Posting Profits – One HMO Loses Money

Posted Nov 15 2009 10:01pm

As everyone is probably aware, Massachusetts is the only state that has required consumers to have health insurance and has been discussed in depth many times.  Their model could be a partial model for our care in the US, but there are still discrepancies and problems that live in their system too.  One item addressed by Paul Levy, CEO of Beth Israel Deaconess Hospital suggests part of the problem is a lack of competition.   That issue is not unique to Massachusetts as other states have some of the same issues.    image

Cost for healthcare in Massachusetts is varied, depending on the plan, facilities and physicians consulted.  Some physicians earn more for the same services provided at other hospitals and as Mr. Levy mentions, this is a vicious cycle, and again this is not unique to Boston or Massachusetts.  One carrier lost money and related the loss to H1N1 care and the economic turndown.  We are all getting older and healthcare will be more expensive today and in the future as we have so many new and different ways to treat disease. Yes, there’s a lot of room for improvement too with eliminating duplication of tests, etc.  Again, until we can work on one end of the problem with technology to cut and eliminate additional costs, the other side with premiums and competition is going to remain at the same levels.  We used to look forward to retirement, but today that is not the American Dream or considered Golden Years by any means, as we seem to be facing the reality that we will be working forever. 

We are getting healthier and with new disease treatments, we can work longer, but again we still need chronic care at affordable prices too in order to keep us going.  Who would have ever thought years ago that we would see such avid marketing and price comparisons in healthcare, and all of that costs money and we pay for that too.  As a patient are you being referred to the best partners, or are you going to where the compensation rates are higher for the facilities and/or doctors?  That’s a tough one to figure out for all of us.  BD 

Three of the four largest health insurers in Massachusetts swung back to profitability in the third quarter, after all four posted second-quarter losses.

Blue Cross and Blue Shield of Massachusetts Inc.’s HMO Blue subsidiary lost $3 million. But as a whole, the Boston firm earned $17.1 million in the quarter on revenue of $1.6 billion. That’s off 70 percent from the same period last year, but much better than the second quarter of 2009, when Blue Cross-Blue Shield lost $33.6 million. The company has lost a total of $53.2 million so far this year.

In addition, the economic downturn has caused many older workers to stay on the job instead of retiring. That means the average age of employees at companies that offer Blue Cross-Blue Shield plans has risen. “An increase in the average age of the population leads directly to increased medical costs,’’ said Maltz.

Three of the four largest Massachusetts health insurers post profits - The Boston Globe

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